How our Dreams Changed During the COVID-19 Pandemic: Effects and Correlates of Dream Recall Frequency - a Multinational Study on 19,355 Adults

Eirin Fränkl; Serena Scarpelli; Michael R Nadorff; Bjørn Bjorvatn; Courtney J Bolstad; Ngan Yin Chan; Frances Chung; Yves Dauvilliers; Colin A Espie; Yuichi Inoue; Damien Leger; Tainá Macêdo; Kentaro Matsui; Ilona Merikanto; Charles M Morin; Sérgio Mota-Rolim; Markku Partinen; Thomas Penzel; Giuseppe Plazzi; Mariusz Sieminski; Yun Kwok Wing; Luigi De Gennaro; Brigitte Holzinger

doi:10.2147/NSS.S324142

How our Dreams Changed During the COVID-19 Pandemic: Effects and Correlates of Dream Recall Frequency - a Multinational Study on 19,355 Adults

Nat Sci Sleep. 2021 Sep 22:13:1573-1591. doi: 10.2147/NSS.S324142. eCollection 2021.

Authors

Eirin Fränkl¹, Serena Scarpelli², Michael R Nadorff^{3

4}, Bjørn Bjorvatn⁵, Courtney J Bolstad³, Ngan Yin Chan⁶, Frances Chung⁷, Yves Dauvilliers⁸, Colin A Espie⁹, Yuichi Inoue^{10

11}, Damien Leger^{12

13}, Tainá Macêdo¹⁴, Kentaro Matsui^{15

16}, Ilona Merikanto^{17

18

19}, Charles M Morin²⁰, Sérgio Mota-Rolim²¹, Markku Partinen^{22

23}, Thomas Penzel²⁴, Giuseppe Plazzi^{25

26}, Mariusz Sieminski²⁷, Yun Kwok Wing⁶, Luigi De Gennaro^{2

28}, Brigitte Holzinger^{1

29}

Affiliations

¹ Institute for Consciousness and Dream Research, Vienna, Austria.
² Department of Psychology, Sapienza University of Rome, Rome, Italy.
³ Mississippi State University, Mississippi State, MS, USA.
⁴ Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
⁵ Department of Global Public Health and Primary Care, University of Bergen, and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
⁶ Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
⁷ Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Canada.
⁸ Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France.
⁹ Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
¹⁰ Department of Somnology, Tokyo Medical University, Tokyo, Japan.
¹¹ Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
¹² Université de Paris, VIFASOM (EA 7331 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France.
¹³ APHP, Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France.
¹⁴ Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil.
¹⁵ Department of Clinical Laboratory and Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry National Institute of Mental Health, Kodaira, Japan.
¹⁶ Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.
¹⁷ Sleep Well Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
¹⁸ Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.
¹⁹ Orton Orthopaedics Hospital, Helsinki, Finland.
²⁰ École de Psychologie, Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada.
²¹ Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil.
²² Helsinki Sleep Clinic, Terveystalo Healthcare, Helsinki, Finland.
²³ Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland.
²⁴ Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany.
²⁵ IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
²⁶ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
²⁷ Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland.
²⁸ IRCCS Fondazione Santa Lucia, Rome, Italy.
²⁹ Medical University Vienna, ZK-Schlafcoaching, Vienna, Austria.

Abstract

Objective: Many have reported odd dreams during the pandemic. Given that dreams are associated with mental health, understanding these changes could provide crucial information about wellbeing during the pandemic. This study explored associations between COVID-19 and dream recall frequency (DRF), and related social, health, and mental health factors.

Methods: We conducted a cross-sectional web survey of 19,355 individuals in 14 countries from May to July 2020. We collected data on COVID-19, mental health, sleep and DRF during the pandemic. We performed McNemar Tests to compare low (<3 nights per week) and high DRF (≥3 nights per week) before and during COVID-19 and to evaluate changes in sleep variables segmented by DRF. Chi-square tests were conducted to compare characteristics between low and high DRF. Logistic regression analyses were conducted to examine associations between various independent variables and DRF.

Results: Reports of high DRF during the pandemic were higher than before the pandemic (P<0.001). Female gender (aOR=1.25, 95% CI 1.10-1.41), nightmares (aOR=4.22, 95% CI 3.45-5.17), sleep talking (aOR= 2.36, 1.73-3.23), sleep maintenance problems (aOR=1.34, 95% CI 1.15-1.56), symptoms of REM sleep behavior disorder (RBD; aOR=1.24, 95% CI 1.09-1.41) and repeated disturbing thoughts (posttraumatic stress disorder (PTSD) symptoms) were associated with high DRF. Age group 55-64 years (aOR=0.69, 95% CI 0.58-0.83) reported less high DRF than younger participants. Unadjusted OR showed associations between depression, anxiety, and DRF; however, in adjusted regression depression (aOR= 0.71, 0.59-0.86) and anxiety (aOR=0.79, 95% CI 0.66-0.94) were negatively associated with high DRF.

Conclusion and relevance: DRF was higher than pre-pandemic levels across four continents. DRF was associated with gender and parasomnias like nightmares and RBD symptoms, sleep maintenance problems, PTSD symptoms and negatively associated with depression and anxiety. The results implicate that COVID-19 is reflected in our dreams as an expression of the emotional intensity of the pandemic.

Keywords: collective threat; mental health; parasomnia; sleep; sleep disorder.

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.